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Minimally invasive lumbar arthrodesis with intermuscular approach without special surgical material: a case series

OBJECTIVES: To analyze the clinical results of a series of patients with degenerative disease of the lumbar spine treated with circumferential arthrodesis with minimally invasive intermuscular approach without special surgical material. METHODS: Analysis of a prospective series of 12 consecutive non-randomized patients undergoing single level lumbosacral fusion for degenerative disease. Oswestry Disability Index (ODI version 2.0) and visual analogue pain scale (VAS) were performed preoperatively and six months after surgery. Arthrodesis was performed with bilateral paramedian approach between the multifidus and longissimus muscles using simple cervical retractor systems and conventional implants. RESULTS: There was an average improvement of 3.6 points on the VAS and 27.5 percentage points in the ODI comparing the evaluations performed preoperatively and six months after surgery. The improvement was higher in patients with sciatica by disc herniation associated with discopathy. There was no additional difficulty related to the technique and surgical material used. CONCLUSIONS: Circumferential lumbosacral arthrodesis with minimally-invasive intermuscular approach can be performed with normal surgical retractors and conventional implants without compromising the clinical outcome on patients with degenerative disease of the spine.

Surgical procedures, minimally invasive; Spine; Arthrodesis; Low back pain


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